Peeters K A B M, Koppelman S J, Penninks A H, Lebens A, Bruijnzeel-Koomen C A F M, Hefle S L, Taylor S L, van Hoffen E, Knulst A C
Department of Dermatology/Allergology, University Medical Center Utrecht, The Netherlands.
Allergy. 2009 Apr;64(4):549-55. doi: 10.1111/j.1398-9995.2008.01818.x. Epub 2008 Dec 4.
The use of lupine in food has been increasing during the last decade and allergic reactions to lupine have been reported, especially in peanut-allergic patients. The frequency and the degree of cross-reactivity to other legumes are not known. The aim of the study was to investigate the frequency of sensitization to lupine, and in addition to pea and soy, and its clinical relevance, in peanut-sensitized patients. Furthermore, to determine the eliciting dose (ED) for lupine using double-blind placebo-controlled food challenges (DBPCFC).
Thirty-nine unselected peanut-sensitized patients were evaluated by skin prick tests (SPT) and ImmunoCAP to lupine, pea, and soy. Clinical reactivity was measured by DBPCFC for lupine, and by history for pea and soy.
Eighty-two percent of the study population was sensitized to lupine, 55% to pea, and 87% to soy. Clinically relevant sensitization to lupine, pea, or soy occurred in 35%, 29%, and 33% respectively of the study population. None of the patients was aware of the use of lupine in food. The lowest ED for lupine, inducing mild subjective symptoms, was 0.5 mg, and the no observed adverse effect level (NOAEL) was 0.1 mg. No predictive factors for lupine allergy were found.
In peanut-sensitized patients, clinically relevant sensitization to either lupine or to pea or soy occurs frequently. The ED for lupine is low (0.5 mg), which is only fivefold higher than for peanut. Patients are not aware of lupine allergy and the presence of lupine in food, indicating that education is important to build awareness.
在过去十年中，羽扇豆在食品中的使用量不断增加，并且已有对羽扇豆过敏反应的报道，尤其是在花生过敏患者中。对其他豆类的交叉反应频率和程度尚不清楚。本研究的目的是调查花生致敏患者中对羽扇豆以及豌豆和大豆的致敏频率及其临床相关性。此外，通过双盲安慰剂对照食物激发试验（DBPCFC）确定羽扇豆的激发剂量（ED）。
对39例未经筛选的花生致敏患者进行了针对羽扇豆、豌豆和大豆的皮肤点刺试验（SPT）和免疫捕获法检测。通过对羽扇豆进行DBPCFC以及对豌豆和大豆通过询问病史来测量临床反应性。
82%的研究人群对羽扇豆致敏，55%对豌豆致敏，87%对大豆致敏。研究人群中分别有35%、29%和33%对羽扇豆、豌豆或大豆有临床相关致敏反应。没有患者意识到食品中使用了羽扇豆。引起轻度主观症状的羽扇豆最低激发剂量为0.5毫克，未观察到不良反应水平（NOAEL）为0.1毫克。未发现羽扇豆过敏的预测因素。
在花生致敏患者中，对羽扇豆或豌豆或大豆的临床相关致敏反应频繁发生。羽扇豆的激发剂量较低（0.5毫克），仅比花生高五倍。患者未意识到羽扇豆过敏以及食品中存在羽扇豆，这表明开展教育以提高认识很重要。
